IMSI
The IMSI method was introduced into clinical practice relatively recently (first introduced in 2001) but quickly attracted the attention of various countries in the field of assisted reproduction. This high-tech and knowledge-intensive method is now widely used in world practice, has been extensively discussed in the scientific literature, and has received very encouraging feedback from reproductive scientists. The term IMSI is a transliteration from the English acronym IMSI (intracytoplasmic morphologically selected sperm injection), the word for word translates as «intactoplasmatic injection of sperm after selection according to morphological criteria». The IMSI is based on the long-established method of ICSI (ICSI – intracytoplasmic sperm injection, «intratoplasmatic injection of sperm»).
What’s the difference between an IMSI and an X? One of the main tasks of an embryologist performing an ISIS procedure is to select a sperm that has normal morphology and mobility. The embryologist, using a microscope with an increase of 400-600 times, selects the sperm with optimum characteristics and then immobilizes it and injects it into the oocyte, thus carrying out the process of fertilization. It is known that, along with other factors, sperm morphology has a significant influence on the result of ICSI. It is sperm with normal morphology that most often possess all the qualities necessary for successful fertilization, embryo development, and implantation.
The IMSI method makes this selection as accurate and efficient as possible. A specially engineered microscope in IMSI makes it possible to consider the finer details of sperm morphology, and therefore more likely to select a sperm of superior quality. This is already the case with a much larger increase, more than 6,000 times. The advantage of IMSI can be explained by comparing the images shown in figures 1, A and 1, B, which show what the sperm looks like when increasing x 400, which is used for ISI (1, A), and increasing x6600 times, which can only be achieved by executing IMSI (1, B).
To whom is the IMSI method shown? The use of IMSI significantly increases the likelihood of a successful program if the malefactor is the primary cause of the couple’s infertility (there are few sperm with normal morphology in the male ejaculate) and yet at least two previous X-rays failed to produce the expected pregnancy. In such cases, a more detailed assessment using the IMSI can identify the defects of impending pregnancy and select only the best quality sperm for fertilization.
What are the benefits of IMSI? Improved sperm selection techniques increase the efficiency of IMSI compared to ICSI in the above-mentioned group of patients, including The rate of implantation is greatly increased, The frequency of pregnancy increases significantly, In some cases, the risk of spontaneous abortion is reduced. It should be borne in mind that IMSI is not a panacea for 100 percent pregnancy. There is no reason to prefer the IMSI if: sperm concentration in the ejaculate of less than 1 million/ml, sperm level with normal morphology less than 1%, the vitality of sperm is reduced, The low quality of oocytes is stable. Furthermore, the IMSI method is not intended to replace ICSI in all cases solely because of its high-tech nature. This method is decided on a case-by-case basis.